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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 371881431
Report Date: 11/22/2025
Date Signed: 11/22/2025 02:00:52 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/16/2023 and conducted by Evaluator Sandra Urena
COMPLAINT CONTROL NUMBER: 18-AS-20231016203222
FACILITY NAME:JOY AND LOVE HOME CARE, LLCFACILITY NUMBER:
371881431
ADMINISTRATOR:SARAPAT, AILA J.FACILITY TYPE:
740
ADDRESS:1178 EVERGREEN LANETELEPHONE:
(661) 754-0261
CITY:VISTASTATE: CAZIP CODE:
92084
CAPACITY:18CENSUS: 16DATE:
11/22/2025
UNANNOUNCEDTIME BEGAN:
12:37 PM
MET WITH:Siva MullapudiTIME COMPLETED:
01:59 PM
ALLEGATION(S):
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Staff did not dispense medication according to doctor's orders.
Staff mismanaged resident's medications.
Staff are not following resident's special dietary needs.

INVESTIGATION FINDINGS:
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On 11/22/2025, Licensing Program Analyst (LPA), Sandra Urena conducted a subsequent unannounced visit to deliver the findings for the allegations listed above. The LPA met with the Licensee Siva Mullapudi over the phone, and explained the reason for the visit. LPA Urena, along with the designated staff, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. No concerns were observed at the time of the visit.

On 10/16/2023, the Centralized Complaint and Information Branch (CCIB) received an online complaint. On 10/19/2023, Licensing Program Analyst (LPA), Venus Mixson arrived unannounced to the facility to initiate an investigation into the listed allegations. LPA Mixson interviewed the Licensee, two residents, two staff and requested and received documents pertinent to the investigation. On 05/22/2024, LPA Mixson arrived unannounced at the facility and conducted a subsequent visit to conduct additional interviews, record reviews, and make observations regarding the listed allegations.
Continues on LIC 9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 4
Control Number 18-AS-20231016203222
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: JOY AND LOVE HOME CARE, LLC
FACILITY NUMBER: 371881431
VISIT DATE: 11/22/2025
NARRATIVE
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pg. 2
Staff did not dispense medication according to doctor's orders.
On the allegation that staff do not dispense medication according to doctors’ orders, it is the concern of the Reporting Party (RP) that R1’s medicine patch was not removed and replaced as prescribed and was two days overdue. On 10/19/2023 and 05/22/202 LPA Venus Mixson conducted interviews, record review pertinent to the allegation and made observations related to the allegation. The interview with one hospice nurse revealed that their client was R1, and that R1did have a medication patch, which was part of R1’s pain management. Furthermore, the hospice nurse stated that it was the responsibility of the Hospice team and the facility staff to care for the replacement and documenting on the condition of the patch. The hospice nurse stated that at no time there were concerns regarding the dispensing of medication according to the doctor's orders or concerns brought to their attention by any residents or staff. On 02/26/2024, LPA Mixson interviewed R1’s responsible party, and the interview revealed that “they are pleased with the overall operation and the running of the facility. There have been some changes put into place to prevent what was a simple mishap”. Furthermore, the party responsible stated that all is well and there are no concerns, there are protocols in place from the Administration, and shared that R1 seems much happier. Interviews conducted with four (4) residents revealed that they have never missed any of their scheduled medications that are prescribed by their doctor. LPA Mixson made observations pertaining to the listed allegation: Medication Administration Records (MARS) charts were reviewed and there was no documentation alluding to "Staff did not dispense medication according to doctor's orders." Additionally, residents’ medication refusals were documented.

Although the allegation may have happened or is valid, based on the interviews, observation, record review, there is not sufficient evidence to prove the alleged violation did or did not occur. Therefore, the allegation that Staff do not dispense medication according to doctor's orders is deemed Unsubstantiated at this time.

Continues on LIC9099C... pg.3
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 18-AS-20231016203222
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: JOY AND LOVE HOME CARE, LLC
FACILITY NUMBER: 371881431
VISIT DATE: 11/22/2025
NARRATIVE
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pg. 3.
Staff mismanaged resident's medications.
On the allegation that staff mismanaged the resident’ medication; it is the concern of the Reporting Party (RP) that the facility’s staff informed R1’s responsible party that at least one of R1’s medications was improperly dispensed and that the hospice nurse could no longer be directly involved with R1’s medication management, and that information was incorrect. To investigate the allegation, LPA Mixson interviewed R1’s hospice nurse, and the hospice nurse indicated that they were not aware or had any concerns regarding the staff mismanaging R1’s medications. LPA Mixson reviewed the residents’ Medication Administration Records (MARS), and the list of residents who were receiving Hospice. There were no documented issues or concerns with medication management or "Staff mismanaging resident's medications" by any of the Hospice Nurses at the time that the observation was made. Interviews with the residents revealed that they have never had any incidents when the wrong medication was given to them by the med techs. LPA Mixson interviewed the licensee Siva who shared that the facility staff did dispense medication according to doctor's orders. The staff were to change the resident’s patch every three days and this was completed, however, what was missing was the logging of the changed patch. The licensee stated that they spoke with the hospice nurse and they figured out “the patch was changed but the staff did not initial on the medication log that it was changed”. LPA Mixson asked the licensee if there was a patch with a date on it, and the licensee said they did not see any date on the patch.

Based on the information obtained through interviews, observation, and record review, there is not sufficient evidence to prove that staff mismanaged the residents’ medication. Therefore, the allegation is deemed Unsubstantiated at this time.



Continues on LIC 9099C...pg. 4.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 18-AS-20231016203222
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: JOY AND LOVE HOME CARE, LLC
FACILITY NUMBER: 371881431
VISIT DATE: 11/22/2025
NARRATIVE
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pg. 4
Staff are not following resident's special dietary needs.
On the allegation that Staff are not following resident's special dietary needs; the concern of the reporting party is that the kitchen staff do not review R1’s food sensitivities and no-go items and indicated that some of those items have been part of R1’s recent meals. To investigate the allegation, LPA Mixson interviewed residents and staff and made observations pertaining to the listed allegations. R1’s hospice nurse stated that there were no concerns brought to their attention regarding staff not following R1’s special dietary needs and that R1 did not share with them that there were any issues with not having food, enough food or special diet food. The LPA interviewed R1’s responsible party and they stated that they visited R1 at the facility, and “everything is nothing but good intentions and all is well”. Four (4) residents’ interviews revealed that they do not have a special diet, and that they get plenty of food and snacks, which some residents keep in their room. Furthermore, LPA Mixson conducted a tour of the kitchen area, and the food supply was adequate as per CCL Regulations. The LPA observed residents eating their meals. LPA Mixson was able to observe that residents with special diets were provided with special meals.

Based on the information obtained through interviews, and observation, there is not sufficient evidence to prove that staff are not following resident's special dietary needs. Therefore, the allegation is deemed Unsubstantiated at this time.



Licensee was away from the facility and the designated facility staff signed off on the report.


No citations were issued. Exit interview was conducted, and a copy of the report was issued.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4